=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992707418
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MOSES S RAJ MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/15/2005
-----------------------------------------------------
Last Update Date | 10/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 268 GILLMAN RD STE A
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28037-7925
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-659-7830
-----------------------------------------------------
Fax | 877-881-8455
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 146 MEDICAL PARK RD STE 212
-----------------------------------------------------
City | MOORESVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28117-8529
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-659-7850
-----------------------------------------------------
Fax | 877-881-8455
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number | 202501466
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------